High-dose Chemotherapy with Peripheral Blood Stem Cell (PBSCT) Support for Recurrent Breast Cancer

Between May 1995 and June 1999 Seven patients with recurrent breast cancer received high dose chemotherapy (HDCT) with autologous peripheral blood stem cell transplantation (PBSCT) . The HDCT regimen consisted of epirubicin (120-260 mg/m? ), cyclophosphamide (0-4000 mg/body) . Medroxy-progesterone (1200 mg/day) was given more than 2 weeks prior to induction chemotherapy. HDCT with PBSCT support was performed on all patients on schedule. No toxic death by chemotherapy occurred. The clinical response was CR in 3, PR in 3 and NC in one patient. The rate of good clinical re-sponse was 86 %. The mean survival duration after recurrence was 24 months (range10-34) . The mean survival period after HDCT was 12 months (range 8-25) . The durations of efficacy were shorter than had been ex-pected. While this treatment resulted in higher rates of clinical response, the prognosis for patients with metastatic tumor was not improved

Postoperative Prognosis of Breast Cancer Patients Predicted by p53 Gene Mutation in Cancer Cells Obtained by Aspiration Biopsy

The method of cytological examination by fine needle aspiration biopsy (FNAB) was developed clinically in breast cancer and enabled us to prepare cancer cell nuclei for the detection of p53 gene mutation. In the expectation that this method would improve the prediction of postoperative prognosis, the observation of 10 year survival for breast cancer patients with p53 gene mutations was done. The DNA of the aspirated cells was examined preoperatively for gene alterations in 53 patients with breast cancer. The p53 protein accumulation, DNA ploidy pattern, estrogen receptor (ER) , and clinicopathological factors were examined postoperatively The postoperative follow up was conducted over 10 years and evaluated the status of p53 gene mutation. In 26 patients (49.1%) , 29 p53 gene mutations were shown. p53 protein accumulations and DNA aneuploidy patterns were detected in 33 (62.3%) and 42 (79.2%) cases, respectively, and both significantly correlated with p53 gene mutations. With regard to the postoperative prognosis, in over 10 years of observation, the patients who showed p53 mutations had a significantly worse prognosis in both disease free survival and overall survival than those showing negative p53 mutation. A similar tendency was also seen in patients with histologic grade 3. Using FNAB, the usefulness of the preoperative detection of p53 gene mutation was revealed, suggesting its clinical benefits for predicting a patient\u27s prognosis

Significance of measurement of tumor marker in primary breast cancer

We investigated a prognosis in the presence or absence of preoperative marker abnormality for 371 cases with primary breast cancer that we experienced in our department this time. 60 (16%) of 371 cases showed the abnormality of the tumor marker and 25 (41.7%) of 60 patients had a recurrence. The positive rate of the marker was 8.1% in CA 15 3, 6.7% in CEA, 4.1% in NCC ST 439, and each rate of recurrence was 56.7%, 48.0%, 33.3%. Rate of recurrence in the negative cases was 12.7%, 13.9, 15.0% respectively and recognized a significant difference statistically (p <0.001) . Of 11 cases (3.8%) shown CA 15 3 abnormal high level, 3 cases (27.2%) had recurrence when we examined in 0 3 metastases to lymph nodes according to markers. 281 cases (96.2%) was normal range in CA15 3. Only 15 cases (5%) had recurrence. It showed a significant difference statistically (p <0.05) . For the cases shown abnormality of the preoperative CA 15 3, careful serial observations are necessary